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NPI Code Detail

MEDICARE: BRAVO CARE OF SWANSEA INC

MEDICARE: BRAVO CARE OF SWANSEA INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1821285586
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRAVO CARE OF SWANSEA INC
Provider Business Mailing Address
First Line : 11701 BORMAN DR STE 315
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63146-4194
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 100 ROSEWOOD VILLAGE DR
Second Line :
City : SWANSEA
State : IL
Zip : 62226-2301
Country : US
Telephone Number : 618-236-1391
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MICHAEL BRADY
Credential :
Telephone Number : 314-994-9070
Provider Enumeration Date : 09/26/2007
Last Update Date : 09/26/2007

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Directions to “BRAVO CARE OF SWANSEA INC ” Practice Location

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